Challenges in healthcare financing for surgery in Sub-Saharan Africa
One-third of the global burden of disease is attributed to surgical conditions yet, 5 billion people globally, lack access to surgery. The Lancet Commission on Global Surgery, Obstetrics, and Anesthesia (LCOGS) published guidelines for improving access by reducing catastrophic health expenditures (C...
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| Format: | Article |
| Language: | English |
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The Pan African Medical Journal
2021-02-01
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| Series: | The Pan African Medical Journal |
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| Online Access: |
https://www.panafrican-med-journal.com/content/article/38/198/pdf/198.pdf
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| _version_ | 1819121799258963968 |
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| author | Juliet Siena Okoroh Robert Riviello |
| author_facet | Juliet Siena Okoroh Robert Riviello |
| author_sort | Juliet Siena Okoroh |
| collection | DOAJ |
| description | One-third of the global burden of disease is attributed to surgical conditions yet, 5 billion people globally, lack access to surgery. The Lancet Commission on Global Surgery, Obstetrics, and Anesthesia (LCOGS) published guidelines for improving access by reducing catastrophic health expenditures (CHEs) by 2030. This is especially important in Sub-Saharan Africa (SSA) where 90% of the extreme poor reside. In this paper, we provide a narrative review of four studies on CHEs for surgical care in SSA published since 2015. We discuss healthcare financing in the countries and summarize the authors’ key findings of out of pocket payments (OOP) and CHEs. Briefly, the studies enrolled 130 to 300 patients and collected direct OOPs via chart review of health costs or patient interviews. Indirect costs were calculated from lost wages and transportation costs. CHEs were defined as health costs exceeding 10% of the GDP per capita or the household income. Despite healthcare being reported as free in all studies, 60%-90% of surgical patients had CHEs with all costs considered. OOPs persists for medicines and anesthesia that should be covered under any health insurance scheme. In some cases, Indirect costs associated with transportation and wages were major drivers of CHEs for surgery. Without addressing these gaps in coverage more people will risk impoverishment in seeking surgical care in SSA. |
| first_indexed | 2024-12-22T06:42:18Z |
| format | Article |
| id | doaj.art-186ca970e45748078ce33b4e173b6eb7 |
| institution | Directory Open Access Journal |
| issn | 1937-8688 1937-8688 |
| language | English |
| last_indexed | 2024-12-22T06:42:18Z |
| publishDate | 2021-02-01 |
| publisher | The Pan African Medical Journal |
| record_format | Article |
| series | The Pan African Medical Journal |
| spelling | doaj.art-186ca970e45748078ce33b4e173b6eb72022-12-21T18:35:24ZengThe Pan African Medical JournalThe Pan African Medical Journal1937-86881937-86882021-02-013819810.11604/pamj.2021.38.198.2711527115Challenges in healthcare financing for surgery in Sub-Saharan AfricaJuliet Siena Okoroh0Robert Riviello1 University of Alabama, Department of Surgery, Birmingham, Alabama, United States of America Brigham and Women´s Hospital, Division of Trauma, Burn, Surgical Critical Care, Boston, Massachusetts, United States of America One-third of the global burden of disease is attributed to surgical conditions yet, 5 billion people globally, lack access to surgery. The Lancet Commission on Global Surgery, Obstetrics, and Anesthesia (LCOGS) published guidelines for improving access by reducing catastrophic health expenditures (CHEs) by 2030. This is especially important in Sub-Saharan Africa (SSA) where 90% of the extreme poor reside. In this paper, we provide a narrative review of four studies on CHEs for surgical care in SSA published since 2015. We discuss healthcare financing in the countries and summarize the authors’ key findings of out of pocket payments (OOP) and CHEs. Briefly, the studies enrolled 130 to 300 patients and collected direct OOPs via chart review of health costs or patient interviews. Indirect costs were calculated from lost wages and transportation costs. CHEs were defined as health costs exceeding 10% of the GDP per capita or the household income. Despite healthcare being reported as free in all studies, 60%-90% of surgical patients had CHEs with all costs considered. OOPs persists for medicines and anesthesia that should be covered under any health insurance scheme. In some cases, Indirect costs associated with transportation and wages were major drivers of CHEs for surgery. Without addressing these gaps in coverage more people will risk impoverishment in seeking surgical care in SSA. https://www.panafrican-med-journal.com/content/article/38/198/pdf/198.pdf health expenditureshealthcare financingglobal healthsub-saharan africahealth care economics and organizationcatastrophic illness |
| spellingShingle | Juliet Siena Okoroh Robert Riviello Challenges in healthcare financing for surgery in Sub-Saharan Africa The Pan African Medical Journal health expenditures healthcare financing global health sub-saharan africa health care economics and organization catastrophic illness |
| title | Challenges in healthcare financing for surgery in Sub-Saharan Africa |
| title_full | Challenges in healthcare financing for surgery in Sub-Saharan Africa |
| title_fullStr | Challenges in healthcare financing for surgery in Sub-Saharan Africa |
| title_full_unstemmed | Challenges in healthcare financing for surgery in Sub-Saharan Africa |
| title_short | Challenges in healthcare financing for surgery in Sub-Saharan Africa |
| title_sort | challenges in healthcare financing for surgery in sub saharan africa |
| topic | health expenditures healthcare financing global health sub-saharan africa health care economics and organization catastrophic illness |
| url |
https://www.panafrican-med-journal.com/content/article/38/198/pdf/198.pdf
|
| work_keys_str_mv | AT julietsienaokoroh challengesinhealthcarefinancingforsurgeryinsubsaharanafrica AT robertriviello challengesinhealthcarefinancingforsurgeryinsubsaharanafrica |